Risk factors for mortality in patients over 70 years old with COVID-19 in Wuhan at the early break: retrospective case series

Abstract

Background Elderly patients with COVID-19 were shown to have a high case-fatality rate. We aimed to explore the risk factors associated with death in patients over 70 years old (yr). Methods In this retrospective study, we enrolled consecutively hospitalized patients over 70 yr with COVID-19 between January 20 and February 15, 2020 in Renmin Hospital of Wuhan University. Epidemiological, demographic, and clinical data were collected. Clinical subtypes, including mild, moderate, severe, and critical types, were used to evaluate the severity of disease. Patients were classified into two groups: survivor and non-survivor groups. Clinical data were compared between the two groups. Univariable and multivariable Cox regression methods were used to explore the risk factors. Results A total of 147 patients were enrolled. The case-fatality rate was 28.6%. Multivariable Cox proportional hazard regression showed that clinical subtypes, including the severe type (HR = 2.983, 95% CI: 1.231–7.226, P = 0.016) and the critical type (HR = 3.267, 95%CI: 1.009–10.576, P = 0.048), were associated with increasing risk of death when compared with the general type. Blood urea nitrogen greater than 9.5 mmol/L (HR = 2.805, 95% CI: 1.141–6.892, P = 0.025) on admission was an independent risk factor for death among laboratory findings. Conclusion The patients over 70 yr with COVID-19 had a high case-fatality rate. The risk factors, including clinical subtypes and blood urea nitrogen greater than 9.5 mmol/L, could help physicians to identify elderly patients with poor clinical outcomes at an early stage.

Routine laboratory parameters, including complete blood count, predict COVID-19 in-hospital mortality in geriatric patients

“…Strong evidence has been accumulated since the beginning of the COVID-19 pandemic that neutrophils play an important role in the pathogenesis of severe disease course and that neutrophilia represents a feasible and inexpensive biomarker of COVID-19 severity ( Wu et al, 2020 ). In COVID-19 patients, neutrophilia associated with lymphopenia was observed in patients with increased disease severity and with poor prognosis ( Picchi et al, 2021 , Yang et al, 2020 , Zhu et al, 2021 ). A number of studies showed a correlation between markers derived from standard blood count tests, such as neutrophil-to-lymphocyte ratio (NLR), derived NLR ratio (dNLR, neutrophil count divided by the result of WBC count minus neutrophil count), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) and systematic inflammatory response in a number of age-related diseases, including cancer ( Xu et al, 2021 , Ying et al, 2014 ), type 2 diabetes mellitus (T2DM) ( Tong et al, 2004 ), cardiovascular diseases (CVD) ( Bhat et al, 2013 , Ji et al, 2021 ), and stroke ( Cai et al, 2021a ).…”

Case fatality and mortality rates, socio‐demographic profile, and clinical features of COVID‐19 in the elderly population: A population‐based registry study in Iran

“…The risk of hospitalization in 74–65 years is five times more than in the age group of 18–29 years. 9 , 10 …”

“…Likewise, the rate of COVID‐19 hospitalization increases with advanced age. The risk of hospitalization in 74–65 years is five times more than in the age group of 18–29 years 9,10 …”

“…The risk of hospitalization in 74-65 years is five times more than in the age group of 18-29 years. 9,10 Since to make the best decisions on COVID-19 prevention and control measures and regulations, an accurate estimation of mortality and epidemiological measures are required, especially fatality and mortality rates and associated comorbidities in high-risk groups.…”

What can the Defence Medical Services learn from the COVID-19 pandemic in order to be ready for the future?

“…COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was first declared a global emergency by the WHO in January 2020,1 with the UK documenting its first case in February 2020 2. SARS-CoV-2 is more transmissible compared with other viral acute respiratory syndromes (ARS),3 with mortality particularly high in those aged 70 years and older 4. Additionally, an increased proportion of COVID-19 symptomatic patients require hospital admission for supportive respiratory management compared with previous ARS pandemics 5.…”